| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,990 |
3,624 |
$359K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
232 |
216 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
227 |
191 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 0001A |
|
25 |
24 |
$480.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
24 |
24 |
$430.25 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
391 |
333 |
$172.10 |
| 0002A |
|
40 |
40 |
$120.00 |
| 81003 |
|
235 |
221 |
$0.00 |
| 99173 |
|
337 |
319 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
91 |
45 |
$0.00 |
| 0071A |
|
14 |
14 |
$0.00 |
| 90734 |
|
18 |
15 |
$0.00 |
| 85018 |
|
243 |
228 |
$0.00 |
| 92551 |
|
122 |
118 |
$0.00 |
| 96127 |
|
102 |
97 |
$0.00 |
| 90686 |
|
29 |
29 |
$0.00 |
| 90688 |
|
18 |
16 |
$0.00 |
| 90651 |
|
36 |
28 |
$0.00 |